Military medicine
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Comparative Study
A comparison of experiences of training emergency care in military exercises and competences among conscript nurses with different levels of education.
The military emergency care education of nurses is primarily concerned with the treatment of soldiers with combat-related injuries. Even though great progress has been made in military medicine, there is still the pedagogical question of what emergency care education for military nurses should contain and how it should be taught. The aim of this study was to describe and compare experiences of training emergency care in military exercises among conscript nurses with different levels of education. ⋯ There were statistical differences between nurses with general nursing education and nurses with a general nursing education and supplementary education. A reasonable implication of the differences is that the curriculum must be designed differently depending on the educational background of the students. Hence, there is an interaction between background characteristics, e.g., the level of previous education and differences pertaining to clinical experience of the participants, and the impact of the exercise itself.
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We are studying associations between selected biomarkers and schizophrenia or bipolar disorder among military personnel. To assess potential diagnostic misclassification and to estimate the date of illness onset, we reviewed medical records for a subset of cases. ⋯ High levels of agreement between investigators and database diagnoses indicate that diagnostic misclassification is unlikely. Discharge procedure initiation date provides a suitable surrogate for disease onset.
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Randomized Controlled Trial
Effect of a probiotics supplementation on respiratory infections and immune and hormonal parameters during intense military training.
This study examined the effect of a probiotics supplementation on respiratory tract infection (RTI) and immune and hormonal changes during the French Commando training (3-week training followed by a 5-day combat course). Cadets (21 +/- 0.4 years) received either a probiotics (n = 24) or a placebo (n = 23) supplementation over the training period. ⋯ A greater increase in dehydroepiandrostane sulfate was observed in the probiotics group after the combat course (p < 0.05). This study suggested that the benefits of a probiotics supplementation in a multistressor environment relied mainly on its capacity to prevent the infection to spread throughout the respiratory tract.
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The increase in women in the military is reshaping the veteran population and Veterans Affairs (VA) health care delivery imperatives. To determine women veterans' perspectives and decision-making about VA health care use, we conducted six focus groups (four VA users and two nonusers) and identified key themes. Barriers to VA use for both VA users and nonusers included lack of information about eligibility and available services. ⋯ VA environment and quality concerns led many women to limit their VA use to women's clinics. These qualitative findings provide a context to highlight where interventions and policies suggested by quantitative findings should focus. Dissemination of accurate information about VA eligibility and services, and continued responsiveness to women's perceptions of care are indicated.
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The aim of this study was to examine the Mangled Extremity Severity Score (MESS) in a combat setting. ⋯ A MESS of >7 correlated with amputation, thus validating the MESS in a combat setting. A young average patient age and high-energy injury mechanism on the battlefield leave ischemic time and shock as the most important factors in dictating whether a MESS is >7 or <7.